Providing telemedicine care across state lines can seem complicated, but it is possible with the right knowledge about state laws, licensing rules, and telehealth best practices. As telemedicine continues to grow, more patients are seeking care outside their home state for convenience, specialty services, or because local providers are unavailable. This guide explains what healthcare professionals need to know to provide telemedicine care outside of Texas safely and legally.

Understanding Interstate Telemedicine

Telemedicine allows patients and providers to connect without being in the same location. However, practicing outside of Texas means following the rules in both your state and the state where your patient is located. Some states have temporary practice laws that allow you to treat patients for a limited time. Others may require you to get a full license or special permit. Knowing these requirements helps prevent legal issues, including accusations of practicing without a license.

Whether your patient is temporarily visiting another state or has moved permanently, the rules still apply. If a patient moves out of state, you may continue providing care if allowed by the state’s laws, but transitioning the patient to a local provider may sometimes be better for long-term care.

Licensing Requirements for Telemedicine Across State Lines

Each state sets its own rules for telemedicine practice. Many states require a full license to provide care, while others allow temporary practice or participation in licensing compacts. The Psychology Interjurisdictional Compact (PSYPACT) is one example that allows licensed psychologists to provide services in other participating states. If your state participates, you must apply for an E.Passport for telepsychology services or an Interjurisdictional Practice Certification for temporary in-person care. Non-participating states will require following temporary or full licensing rules.

For doctors, providing care outside Texas typically requires being at least 21 years old, holding a valid license in another state without disciplinary actions, passing any required jurisprudence exams, and submitting an application for an out-of-state telemedicine license. Some states offer limited licenses that restrict the type of care or how long you can provide services, which may be a good option for specific cases.

Temporary Practice and Emergency Care

Temporary practice laws allow healthcare providers to treat patients for a limited time in a different state. Some states also have emergency provisions allowing care when a patient’s situation is urgent, such as in life-threatening conditions or crises. Even in emergencies, providers must make reasonable efforts to follow jurisdictional rules, including contacting state boards or professional liability insurers for guidance.

Trainees or students typically cannot practice across state lines without a license. Temporary rules during the COVID-19 pandemic sometimes allowed exceptions, but most of those waivers have expired. Providers should always confirm current rules before providing care outside Texas.

Telemedicine Modalities and Technology

Telemedicine can be delivered in several ways, and each type has specific advantages:

• Synchronous telemedicine: Real-time video or phone appointments where patients and providers interact directly.
• Asynchronous telemedicine: Communication without live interaction, such as emails, questionnaires, or text messages.
• Remote patient monitoring (RPM): Devices that collect data like blood pressure, heart rate, or blood sugar and send it to providers.

Using multiple modalities increases flexibility and allows patients to receive care regardless of location, time zone, or travel restrictions. RPM, in particular, can improve chronic disease management by allowing frequent monitoring without requiring office visits.

Telemedicine Growth and Patient Demand

The COVID-19 pandemic dramatically increased telemedicine use. Medicare telehealth visits grew 63-fold from 2019 to 2020, and millions of patients used telehealth for the first time. Surveys show that most patients are willing to continue using telemedicine. Physicians are also adopting telehealth at higher rates, using it for chronic disease management, diagnosis, and treatment. This demonstrates that telemedicine is both effective and accepted by patients and providers.

Expanding access to telemedicine can address healthcare shortages, particularly in rural areas. Texas has 246 counties classified as mental health professional shortage areas, and many counties lack psychiatrists or licensed counselors entirely. Telemedicine helps patients in these areas access care that would otherwise be unavailable.

Financial and Practical Benefits of Telemedicine

Telemedicine saves time and money for both patients and providers. Patients avoid long travel times, which can be especially important for chronic illness monitoring. For example, patients with hypertension or diabetes can have regular check-ins without leaving home, reducing complications and improving outcomes. Telehealth visits for cancer patients have been shown to save money on travel and lost income, while also reducing time spent driving to appointments.

Medicare and Medicaid also benefit from telemedicine cost savings. Estimates show that telehealth could save Medicare $100 million by 2024 and $170 million by 2029. Reducing hospitalizations through RPM and virtual visits lowers healthcare costs while maintaining high-quality care.

Learning From Other States

States like Florida and Indiana have created pathways for out-of-state providers to practice safely. Florida’s telehealth registry approved over 14,000 providers with very few complaints, demonstrating that expanded access can be achieved without compromising patient safety. Indiana allows out-of-state providers to practice as long as they accept the jurisdiction of state courts.

These examples show that regulatory systems can allow providers to offer care across state lines while maintaining accountability and safety. Texas can adopt similar reforms to improve patient access and reduce provider shortages.

Risks and Legal Considerations

Providing care outside of Texas without meeting licensing requirements can result in serious legal consequences. Accusations of practicing without a license may lead to fines, disciplinary action, or civil liability. Consulting with professional liability insurers and following state-specific regulations is critical to reduce risk. Providers must also ensure compliance with patient privacy laws in the patient’s state or country, including telehealth data security and HIPAA requirements.

Even with temporary or emergency allowances, understanding jurisdictional rules and maintaining proper licensure protects both the patient and the provider.

Best Practices for Providers

• Verify licensing requirements in the state where the patient is located.
• Use appropriate telemedicine modalities for each patient.
• Document all care thoroughly, including communication methods and consent.
• Consult professional liability insurers for cross-state practice guidance.
• Monitor patient outcomes and adjust care plans as needed.
• Stay informed about state and federal telehealth regulations, as rules may change.

Get Legal Guidance

Providing telemedicine care outside of Texas is achievable if you follow state licensing requirements, use appropriate telehealth technology, and prioritize patient safety. Expanded access benefits patients, especially those in rural areas or with limited local providers. Lessons from other states show that telemedicine can increase access safely while improving care outcomes and reducing costs.

Healthcare providers interested in offering telemedicine outside Texas should contact legal experts to confirm licensure requirements and minimize risk. With the right preparation, you can expand your practice and help patients receive care when and where they need it.

Call (972) 290-1031 for guidance on legally providing telemedicine care outside of Texas and protecting your practice.